Abstract
BackgroundData regarding human papillomavirus (HPV) prevalence and genotype distribution are limited in Shandong Province, China. Therefore, we investigated the recent HPV prevalence and genotype distribution among females in Shandong and aimed to provide comprehensive data to guide HPV-based cervical cancer screening and HPV vaccination for this population of Chinese women.MethodsHPV testing results of 94,489 females were retrospectively reviewed and extracted from the database of Jinan KingMed Diagnostics, the largest independent pathology laboratory in Shandong Province, China. HPV was detected by a HPV genotyping panel from January 2011 to June 2017. The overall prevalence, age-specific prevalence, and genotype distribution were analyzed.ResultsA total of 26,839 cases (28.4%) were HPV-positive, with 4.3% positive for low- or undetermined-risk HPV (lr-/urHPV)-only, 18.1% positive for high-risk HPV (hrHPV)-only, and 6.1% positive for mixed lr-/urHPV and hrHPV infections. Single HPV infections accounted for 62.8%, while the rest were multiple HPV infections of two or more genotypes. HPV16 (5.8%), HPV52 (5.1%), HPV58 (3.5%), HPV51 (2.6%), and HPV56 (2.3%) were the five most common hrHPV genotypes; while HPV81 (2.8%), HPV53 (2.8%), and HPV6 (2.3%) were the three most common lr-/urHPV genotypes. HPV18 (1.7%) was only the ninth most common hrHPV genotype. HPV16 but not HPV52 was more common in single infections than in multiple infections. The distribution of both mixed lr-/urHPV and hrHPV as well as overall HPV infections demonstrated a bimodal pattern across age groups, of which the first peak appeared in the younger group and the second peak was found in older women. A similar age-specific distribution was observed in multiple infections of three or more subtypes as well. Moreover, the proportion of mixed lr-/urHPV and hrHPV infection significantly increased, while those of lr-/urHPV-only and hrHPV-only infections declined as the number of co-infections increased during the study period.ConclusionThis large daily clinical practice report shows that HPV prevalence and genotype distribution are different in this population, who had limited cervical cancer screening service, compared to those in developed countries. Therefore, different strategies should be developed for HPV-based cervical cancer screening and vaccine-based HPV prevention in Shandong Province.
Highlights
Approximately 85% of the estimated 528,000 new cases and about 87% of 266,000 deaths from cervical cancer occurred in developing countries in 2012 [1]
The proportion of mixed lr-/urHPV and high-risk HPV (hrHPV) infection significantly increased, while those of lr-/urHPV-only and hrHPV-only infections declined as the number of co-infections increased during the study period. This large daily clinical practice report shows that human papillomavirus (HPV) prevalence and genotype distribution are different in this population, who had limited cervical cancer screening service, compared to those in developed countries
Different strategies should be developed for HPV-based cervical cancer screening and vaccine-based HPV prevention in Shandong Province
Summary
Approximately 85% of the estimated 528,000 new cases and about 87% of 266,000 deaths from cervical cancer occurred in developing countries in 2012 [1]. Effective implementations of cervical screening programs have already successfully lowered the incidence and mortality of cervical cancer in developed countries [2,3,4,5]. Other common HPV genotypes, such as HPV6, 11, 42, 43, 53, 73, 81, 82, and 83, are indefinitely or not carcinogenic to humans but are causative agents for benign warts in the genital tract, vulva, and perianus; they are classified as low- or undetermined-risk HPV (lr-/urHPV) genotypes [11]. Data regarding human papillomavirus (HPV) prevalence and genotype distribution are limited in Shandong Province, China. We investigated the recent HPV prevalence and genotype distribution among females in Shandong and aimed to provide comprehensive data to guide HPV-based cervical cancer screening and HPV vaccination for this population of Chinese women
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